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Effects of pretransplant plasmapheresis and rituximab on recurrence of focal segmental glomerulosclerosis in adult renal transplant recipients

The Korean Journal of Internal Medicine 2014년 29권 4호 p.482 ~ p.488

박훈석(Park Hoon-Suk) - Catholic University College of Medicine Department of Internal Medicine
(Hong Yuah) - Catholic University College of Medicine Department of Internal Medicine
선인오(Sun In-O) - Catholic University College of Medicine Department of Internal Medicine
정병하(Chung Byung-Ha) - Catholic University College of Medicine Department of Internal Medicine
김형욱(Kim Hyung-Wook) - Catholic University College of Medicine Department of Internal Medicine
최범순(Choi Bum-Soon) - Catholic University College of Medicine Department of Internal Medicine
박철휘(Park Cheol-Whee) - Catholic University College of Medicine Department of Internal Medicine
진동찬(Jin Dong-Chan) - Catholic University College of Medicine Department of Internal Medicine
김영수(Kim Yong-Soo) - Catholic University College of Medicine Department of Internal Medicine
양철우(Yang Chul-Woo) - Catholic University College of Medicine Department of Internal Medicine

Abstract

Background/Aims: Recurrent focal segmental glomerulosclerosis (FSGS) following renal transplantation is relatively common. However, the risk factors and optimal pretransplant treatment preventing recurrence of FSGS remain controversial.

Methods: We retrospectively reviewed 27 adult renal transplant recipients with FSGS over a period of 10 years. We first compared possible risk factors for FSGS recurrence between the recurrence and nonrecurrence groups. Then we evaluated the effect of pretransplant plasmapheresis (PP; n = 4) and PP with rituximab (PP + RTX; n = 5) on recurrence of FSGS after transplantation compared to control patients that were not treated with these modalities.

Results: There were seven recurrences in 27 patients (25.9%), but there were no significant differences in possible risk factors for FSGS recurrence between the two groups. Recurrence rates between patients with pretransplant PP or PP + RTX and control patients were not significantly different (22.2% vs. 27.7%, p > 0.05). There was also no significant difference in recurrence between the pretransplant PP and PP + RTX groups (25% vs. 20%, p > 0.05).

Conclusions: Pretransplant PP or PP + RTX do not significantly decrease the recurrence of FSGS in adult renal transplant candidates.